Professional Documents
Culture Documents
Laryngeal Cancer
Laryngeal Cancer
CANCER
Duong Thi My
American Cancer Society: Cancer Facts and Figures 2008. Atlanta, Ga: American
Cancer Society, 2008
III. ANATOMY - SUBDIVISION
IV. TNM CLASSIFICATION AND STAGING
Fixed
Source: Greene FL, Page DL, Fleming ID, et al. (editors). American Joint Committee
on Cancer Staging Manual, 6th edition, New York: Springer-Verlag, 2002
IV. TNM CLASSIFICATION AND STAGING
IV. TNM CLASSIFICATION AND STAGING
V. DIAGNOSIS OF LARYNGEAL CANCER
1. History.
“any patient in cancer age group having persistent or
gradually increasing hoarseness for 3 weeks must have
laryngeal examination to exclude cancer”
- Other symptoms: Throat pain, dysphagia, referred pain in
the ear, or mass of lymph nodes in the neck
- Late feature: Weight loss, stridor, respiratory obstruction,
halitosis
2. Indirect laryngoscopy
- Appearance of lesion
- Vocal cord mobility
- Extent of disease
V. DIAGNOSIS OF LARYNGEAL CANCER
3. Examination of neck
- Extralaryngeal spread of disease
- Nodal metastasis
4. Radiography: CT scan or MRI:
- Evaluate pre-epiglottic or paraglottic space
- Laryngeal cartilage erosion
- Cervical node metastasis
Certain
5. Direct laryngoscopy diagnostic
- The hidden areas of larynx test
- Extent of disease
6. Supravital staining and biopsy
VI. TREATMENT OF LARYNGEAL CANCER
Treatment
Organ
preservation
(early stage)
Conservation Total
laryngeal surgery laryngectomy Surgery with
pre- or
postoperative
radiotherapy
GLOTTIC CARCINOMA
1. Carcinoma in situ:
Frontolateral
Excision of cord partial
laryngectomy
Fails
total laryngectomy
- Mobility of vocal cord?
- Involvement of anterior commissure
and/or arytenoid? T2N0
Failure Vertical
hemilaryngectomy
Conservation Conservation
Failure laryngectomy laryngectomy
Frontolateral
Failure Failure laryngectomy
Subglottic
cancer
T1,T2 T3,T4
Total
laryngectomy and
Radiotherapy P.R
Subglottic
cancer
Supraglottic cancer
T1 T2 T3 , T4
Lung
function
Radiation or
total laryngectomy
excised with CO2 laser good poor
with neck
dissection
supraglottic laryngectomy and P.R to neck
With or without
neck dissection radiotherapy
Radiotherapy
- Cord mobility: normal
Total laryngectomy:
- T lesions (i.e. with cord fixed)
3
- All T lesions
4